Late entry narcotic waste

[DC4Life]

I work at a small rural hospital. On my unit, only two nurses are typically on duty. The past few nights, it has been me and a traveler. The travel nurse had a patient who was getting Dilaudid through the night. I saw her waste the excess Dilaudid for each administration. She shot it into the sink at the nurses station and we talked about how it was such a waste when the patient would be wanting more in a couple hours. We have an old school narcotic cart where you pull your meds out using a physical key and then physically sign them out. On our actual charting system, it alerts you that you are scanning a dose too much and asks how much you are actually administering. The travel nurse did not realize she had to document waste on the paper narcotic sign out, because she was documenting on the patient MAR. She asked me about it last night and I told her yes, she needs to sign her waste on the paper sheet. She went back and "late entried" the Dilaudid wastes on the paper sheet, and I signed behind her because I do know for a fact that she wasted it. I emailed the pharmacy and let them know why the count sheet looked weird with the late entry wastes, and that I did  see the travel nurse waste into the sink. Is this going to be an issue? I was thinking about it after I got home and I'm afraid I will get in trouble for witnessing the late entry wastes. Thank you!

[JKL33]

No it should not be a major issue and don't talk/act nervous about it as if it is.

Question, though: Are you not usually required to document your witnessing of wastes? If you are, then for your own safety this should be the first thing you do after you witness someone's waste.

[DC4Life]

1 minute ago, JKL33 said:

No it should not be a major issue and don't talk/act nervous about it as if it is.

Question, though: Are you not usually required to document your witnessing of wastes? If you are, then for your own safety this should be the first thing you do after you witness someone's waste.

Yes, we are supposed to. I wasn't thinking of it at the time, and that's my fault. I should have told her to make sure she wrote it down and that I would sign after her. So I'm nervous about that being an issue if anything.

[JKL33]

Let it be. You have already emailed to explain things. The real issues occur when you compromise the even more important parts (such as not witnessing the waste in the first place). Nothing inappropriate happened with the actual medication. Don't give people tacit permission/leeway to blow things out of proportion. If an authority figure approaches you about it just use a pleasant but clearly "business" demeanor to affirm what happened (keep your words minimal) and then state, "This was corrected as soon as recognized using appropriate principles of documentation."

I do think admin bullies people over everything narcotic, just like everything HIPAA and a bunch of other stuff. But...expect the best. If they are upstanding people then the main thing they are concerned with is what actually happened to the med. Don't invite them to be ridiculous about it.

It'll be okay.

[DC4Life]

Thank you!